Optimizing vitamin D naming conventions in computerized order entry to support high-value care.

Area of Science:

• Clinical Chemistry
• Health Informatics
• Quality Improvement

Background:

• Overutilization of rare laboratory tests, such as 1,25-OH vitamin D, contributes to healthcare waste.
• Computerized provider order entry (CPOE) systems can inadvertently increase test ordering.
• Non-interruptive decision support tools are sought to optimize test utilization.

Purpose of the Study:

• To decrease wasteful ordering of rare 1,25-OH vitamin D tests.
• To evaluate the impact of modifying test catalog names within a CPOE system.

Main Methods:

• A time series quality improvement study was conducted at two academic hospitals.
• Test titles within the CPOE system were revised to emphasize test purpose and rarity.
• Interruptive time series analyses were used to assess changes in test utilization.

Main Results:

• Introduction of CPOE initially increased monthly 1,25-OH vitamin D test orders.
• Subsequent changes to test catalog names led to a significant decrease in monthly test orders.
• Altering the search order of tests did not impact utilization rates.

Conclusions:

• Modifying catalog names in CPOE systems is an effective strategy to reduce the overuse of infrequently ordered tests.
• This non-interruptive intervention may be preferable to more restrictive methods.
• Healthcare institutions should integrate human factors engineering into CPOE interface design and monitor test utilization post-implementation.